• The Journal of the Korean dental association
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• v.57 no.7
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• pp.380-391
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• 2019

In recent years, with the introduction of various restorative materials, restorations using CAD/CAM equipment have been increasing in the esthetic dentistry. The critical steps in the fabrication of indirect restorations with CAD/CAM equipment are proper cavity preparation and making accurate impressions. The process of tooth preparation for CAD/CAM restoration should include a mechanical understanding of milling. In addition, during tooth preparation, the clinician should be familiar with additional equipment and techniques for obtaining the convenience. In order to obtain an accurate oral scan, the clinician should understand the limitations of the oral scan and be skilled at techniques for obtaining a successful image when making oral scans. This article focused clinical guidelines for the preparation of CAD/CAM restorations and introduced clinical methods for making successful impression of oral scans in narrow and deep tooth cavity areas.

• Journal of Dental Anesthesia and Pain Medicine
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• v.20 no.4
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• pp.241-250
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• 2020

Background: Placement of full-coverage restorations such as stainless steel crowns (SSCs) for pulpectomy treated primary molars is essential for successful outcomes. The tooth preparation process for SSCs can cause discomfort to gingival tissues since the crown should be seated 1 mm subgingivally. The purpose of this prospective trial was to compare the effectiveness of subgingival and transmucosal application of topical anesthetics on dental pain during SSC tooth preparation among 6- to 8-year-old children. Methods: A consecutive sample of 27 children, aged 6-8 years, who required an SSC after pulp therapy in primary molars were randomly divided into three groups. Group A received infiltration anesthesia before tooth preparation for SSC placement, whereas in Group B and C, only topical anesthesia was applied subgingivally and transmucosally. Wong-Bakers Faces pain rating scale (WBFPS) scores were recorded after tooth preparation. Faces, Legs, Activity, Cry and Consolability (FLACC) scores were evaluated by two blinded and calibrated investigators through video recordings of the patient during tooth preparation. Data were tabulated, and inter-group comparisons were performed using the Kruskal-Wallis and analysis of variance tests. Results: Out of the 27 participants, 48% were boys and 52% were girls, with an overall mean age of 6.83 years. Group A showed the least pain scores according to both the scales, followed by Group B and Group C. The pain intensity was statistically significant on both the pain scales with P = 0.003 for FLACC and P < 0.001 for WBFPS. Conclusion: Subgingival application of topical anesthesia reduced pain to a certain extent but not as effectively as infiltration anesthesia during SSC tooth preparation in primary molars. Transmucosal application of topical anesthesia did not reduce discomfort when compared to the other two interventions.

• The Journal of Advanced Prosthodontics
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• v.9 no.6
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• pp.416-422
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• 2017

PURPOSE. To investigate the effect of reducing tooth preparation and ceramic thickness on fracture resistance of lithium disilicate crowns. MATERIALS AND METHODS. Specimen preparation included a standard complete crown preparation of a typodont mandibular left first molar with an occlusal reduction of 2 mm, proximal/axial wall reduction of 1.5 mm, and 1.0 mm deep chamfer (Group A). Another typodont mandibular first molar was prepared with less tooth reduction: 1 mm occlusal and proximal/axial wall reduction and 0.8 mm chamfer (Group B). Twenty crowns were milled from each preparation corresponding to control group (n=5) and conditioned group of simultaneous thermal and mechanical loading in aqueous environment (n=15). All crowns were then loaded until fracture to determine the fracture load. RESULTS. The mean (SD) fracture load values (in Newton) for Group A were 2340 (83) and 2149 (649), and for Group B, 1752 (134) and 1054 (249) without and with fatigue, respectively. Reducing tooth preparation thickness significantly decreased fracture load of the crowns at baseline and after fatigue application. After fatigue, the mean fracture load statistically significantly decreased (P<.001) in Group B; however, it was not affected (P>.05) in Group A. CONCLUSION. Reducing the amount of tooth preparation by 0.5 mm on the occlusal and proximal/axial wall with a 0.8 mm chamfer significantly reduced fracture load of the restoration. Tooth reduction required for lithium disilicate crowns is a crucial factor for a long-term successful application of this all-ceramic system.

• Journal of the Korean Academy of Esthetic Dentistry
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• v.13 no.2
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• pp.13-24
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• 2004

In everyday dental practice, one of the most important procedures is fixed prosthodontics which includes gold and ceramic restorative treatments. This procedure can be divided into tooth preparation, impression taking, laboratory work, occlusal adjustment and cementation. The first step is tooth preparation and it needs not only good techniques but also deep knowledge and understanding of oral biology. Also, there must be good knowledge of the principles and materials of the procedure. The patient's satisfaction can be achieved from natural contour, good shade, and precise margin fit, especially in ceramic restorations on anterior regions. It is essential to fastidiously prepare the tooth to make aesthetic restorations with a good margin fit. Tooth preparation techniques and three case reports of ceramic restorations on the anterior region are presented and discussed in this paper.

• Journal of Dental Rehabilitation and Applied Science
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• v.35 no.4
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• pp.220-227
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• 2019

Purpose: The purpose of this study was to compare the degree of tooth preparation abilities of students according to three self-assessment methods. Materials and Methods: forty-eight sophomores in Kyungpook National University College of Dentistry were divided into three experimental groups. Students performed tooth preparation of the left mandibular first molar for full gold crown. They performed self-assessment using the three methods (visual, digital, and putty index self-assessment group), and reperformed tooth preparation. An intraoral scanner was used to scan each tooth model (prepared tooth and unprepared tooth), and data were acquired in standard tessellation language (STL) file format. The STL files of prepared tooth and unprepared tooth were superimposed using the 3-dimensional analysis software (Geomagic control X). And the reduction amount was measured. In the statistical analysis, all values of reduction amount were analyzed with the Wilcoxon signed rank test and Kruskal-Wallis test (α = 0.05). Results: The three self-assessment methods showed statistically significant differences (P < 0.001). The putty index self-assessment group showed the highest reduction in error than the digital self-assessment method. Conclusion: Within limitations of this study, students showed significant differences in improvement of tooth preparation ability according to the three self-evaluation methods.

• Oral Biology Research
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• v.42 no.4
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• pp.235-240
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• 2018

Standard oral and maxillofacial three-dimensional model was developed with patients' medical data while virtual reality (VR) simulator was developed in conjunction with head mount display (HMD) and Haptic device. The objective of this study was to evaluate the preclinical use of a VR training simulator in tooth preparation practice. Eighty-nine dental students were trained how to operate the simulator. The participants were then given sufficient time on the simulator to practice dental preparation. The students experience and opinion was then taken in through filling of questionnaires. On average content received 1.8 points, anatomy had 2.5 points, 2.6 points for the applicability, and 2.0 for the usability. As for the detailed items scores, queries about the possible development of the simulator and the interest of the learning process through the simulator were the highest at 3.1 and 3.0 points, respectively. Question about the benefit of the HMD and the haptic device during the practice had 1.5 and 1.6 points, respectively. The average total score was 2.2 points. VR tooth preparation simulator in the field of clinical dental education has powerful potential in regard to realistic models, environments, vision, posture, and economical efficiency.

• Restorative Dentistry and Endodontics
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• v.22 no.2
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• pp.546-559
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• 1997

The purposes of this study were to evaluate the efficiency of cavity preparation and to determine the incidence of tooth crack when root-end retrograde cavity preparation was done with ultrasonics. 91 distobuccal root-ends of extracted human maxillary first molars were cut by 3 mm perpendicularly to the long axis of tooth using a slow speed diamond saw, retrocavities were prepared using a slow-speed no. 2 round bur as controls, and stainless steel ultrasonic tips of power settings of 1 through 10 as experimentals. Time consumed and the number of strokes used for the cavity preparation were measured and evaluated, and the incidence of tooth cracks was observed under a stereomicroscope. The results were as follows : For the retrograde cavity preparation, time and number of strokes used were decreased as the ultrasonic power setting increased (p<0.001). High power setting of ultrasonics induced significantly more tooth cracks than did the slow-speed bur or low- and medium power setting of ultrasonics (p<0.05). Teeth with previous crack induced significantly more tooth cracks than those without previous one when high power setting of ultrasonics were used for the retrograde cavity preparation (p<0.001). Teeth with initial apical canal size of no. 10 induced significantly more crack than did those with size of no. 15 when low power setting of ultrasonics were used for the retrograde cavity preparation (p<0.05).

• The Journal of Advanced Prosthodontics
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• v.10 no.4
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• pp.286-290
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• 2018

PURPOSE. Conventional resin-bonded fixed partial dentures (RBFPDs) are usually made with a two-retainer design. Unlike conventional RBFPDs, cantilever resin-bonded fixed partial dentures (Cantilever RBFPDs) are, for their part, made with a single-retainer design. The aim of this study was to compare the effect of tooth surface preparation on the bond strength of zirconia cantilever single-retainer RBFPDs. The objective is to evaluate the shear bond strength of these single-retainer RBFPDs bonded on 3 different amount of tooth surface preparation. MATERIALS AND METHODS. Thirty extracted bovine incisors were categorized to 3 groups (n=10), with different amounts of tooth surface preparations. Teeth were restored with single-retainer RBFPDs with different retainer surfaces: large retainer of $32mm^2$; medium retainer of $22mm^2$; no retainer and only a proximal connecting box of $12mm^2$. All RBFPDs were made of zirconia and were bonded using an adhesive system without adhesive capacity. Shear forces were applied to these restorations until debonding. RESULTS. Mean shear bond strength values for the groups I, II, and II were $2.39{\pm}0.53MPa$, $3.13{\pm}0.69MPa$, and $5.40{\pm}0.96MPa$, respectively. Statistical analyses were performed using a one-way ANOVA test with Bonferroni post-hoc test, at a significance level of 0.001. Failure modes were observed and showed a 100% adhesive fracture. CONCLUSION. It can be concluded that the preparation of large tooth surface preparation might be irrelevant. For zirconia single-retainer RBFPD, only the preparation of a proximal connecting box seems to be a reliable and minimally invasive approach. The differences are statistically significant.

• The Journal of Korean Academy of Prosthodontics
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• v.60 no.1
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• pp.80-90
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• 2022

With the development of digital dentistry, it is being applied in various ways of dental treatment. This case report presents the definitive prosthesis designed in advance with a re-established vertical dimension and the digital technology, which determined the amount of tooth preparation, in order to preserve as much tooth structure as possible in a patient with pathological wear of the posterior teeth and loss of vertical dimension. For accurate tooth preparation, the guides of the occlusal and axial surfaces were digitally and additively manufactured. Then, aesthetics and anterior guidance were established at the provisional stage. The information of the provisional restoration was delivered to the definitive stage by double scanning. The digital technology, including the virtual planning and the guided tooth removal, produced the definitive restorations satisfactory to both the patient and clinician.

• Journal of Dental Rehabilitation and Applied Science
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• v.17 no.4
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• pp.257-274
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• 2001

To properly prepare teeth, dentists require a direct view of the working area and are often placed in a difficult position, moreover, a high proportion of dentists suffer from headache and back pain. Dentists who make use of the dental mirror and position their patients carefully to gain a proper view report less headache, pain and discomfort in the shoulders. It is recommended that dentists learn the "Home Position(H.P.)" which among the various "Random Position(R.P.)" methods, enables dentists to approach their patients in a stable posture. The purpose of this study was to compare tooth preparation in the H.P. and the R.P., and evaluate the clinical efficacy of the H.P.. Tooth preparation for a full cast crown was performed on the maxillary left 1st molar using the H.P. and the R.P., and the shapes of the prepared tooth surfaces at the two different operating positions were compared. The amount of occlusal reduction, marginal width, height, and axial taper were measured and analyzed. A T-test was performed separately to compare the results of the H.P. and the R.P. with respect to the accuracy of the corresponding tooth reduction. The results were as follows. ; 1. The amount of occlusal reduction was excessive on the mesiobuccal cusp(P<0.05), and deficient on the lingual cusp in the H.P.(P<0.01). In the R.P., this was excessive on the buccal cusp and deficient on the fossa and distolingual cusp(P<0.01). 2. The amounts of marginal width were excessive in all areas except on the lingual and mesial surfaces in the H.P. and lingual surface in the R.P.(P<0.01). 3. The marginal heights were achieved more accurately in the R.P. than the H.P.(P<0.01). 4. Axial surface taper was excessive in all areas in the H.P.(P<0.01). But the axial taper of measured areas was even, and tooth is more like to retain its original axis after reduction. In the R.P., axial surface taper was excessive on the mesial and buccal area, and deficient on the distolingual area(P<0.01), and therefore, the axis of the prepared teeth was tipped in the distolingual direction. 5. The times needed for preparation were 12 minutes and 49 seconds in the H.P., and 11 minutes and 35 seconds in the R.P., and the R.P. was statistically faster(P<0.01). The tooth preparation in the H.P. achieved its goal, in that it enabled the operator to make even tooth reduction. In conclusion, the H.P. system offers an improved method that can be used in clinic after specific training.